What Is A Migraine Cocktail: ER And At Home


What is a Migraine Cocktail?

A migraine cocktail is a combination of medications and treatments that can be done at home, in an outpatient center, an emergency department, or when someone is admitted to a hospital for treatment of migraine. Knowing what is a migraine cocktail can help you make better-informed medical decisions. If you are experiencing a severe migraine attack and are not finding relief from your usual treatments, you may want to visit the hospital. But first off, what is migraine?

What is Migraine?

Migraine is a neurological disease associated with headaches that can cause severe throbbing pain or a pulsing sensation, usually on one side of the head. It’s often accompanied by nausea, vomiting, and extreme sensitivity to light and sound. You may want to find out if you are experiencing these common migraine symptoms to know if you suffer from migraine.

What is in a Migraine Cocktail?

Migraine cocktail ingredients include a combination of medications and treatments to help relieve pain from the migraine attack. If you go to the emergency department with a migraine attack, you may receive migraine cocktail IV. Migraine cocktail ingredients can consist of:

  1. Non-steroidal anti-inflammatory drugs (NSAIDs) (Advil)
  2. Acetaminophen (Tylenol)
  3. Magnesium
  4. Medications to reduce nausea or vomiting
  5. Diphenhydramine (Benadryl®)
  6. Dihydroergotamine or IV fluids to help with hydration
  7. Dexamethasone: This medication is a type of steroid and reduces inflammation in the body. Research suggests dexamethasone may help prevent migraine from coming back after initial treatment.

If your migraine attack isn’t responding to your typical medications or OTC medicine or if the migraine attack lasts over 72 hours, it might be time to consider a migraine cocktail.

When is it time to visit the emergency room (ER)?

If your typical medical treatments are not working and your migraine attack lasts more than 3 days, you should consider visiting urgent care or the emergency room (ER) to help alleviate the migraine attack symptoms. It’s also typical to go to the hospital for treatments if it’s your first time experiencing a migraine attack or migraine aura. 

During your hospital visit, doctors may want to rule out any other possibilities of neural conditions such as a stroke so be sure to communicate all of your symptoms to get an accurate diagnosis and treatment for migraine. After the nurse practitioner or physician assistant checks in with you, a nurse will administer medications. 

If the migraine cocktail you receive stops your migraine attack, it’s important to keep note of what worked for future reference. 

Migraine Cocktails In Emergency Room (ER) or Emergency Departments

Migraine cocktails can also be used in the emergency room or emergency department. In the emergency room (ER), opioids are only considered a potential treatment option for acute migraines after other methods have been tried. More effective options for treating acute migraines in the ER include nonsteroidal anti-inflammatory drugs, antiemetic medications, diphenhydramine, dexamethasone, and intravenous fluids. Research has shown that these treatments are more effective when they are given all at once in a migraine cocktail, rather than being given in stages throughout the ER visit.

Making OTC Migraine Cocktails At Home

If you find that your migraine attack is not severe enough to visit the hospital, you might consider an over-the-counter migraine cocktail or an OTC migraine cocktail at home. Migraine cocktails at home have ingredients comprising:

  • Acetaminophen, 250 milligrams (mg)Trusted Source
  • Aspirin, 250 mg
  • Caffeine, 65 mg

That being said, you should consult your physician before trying any homemade migraine cocktail. OTC migraine cocktails can cause side effects, the most common include headaches, dizziness, and drowsiness. The American Migraine Foundation recommends not using OTC medications too often, or they can cause medication overuse headaches. “Most OTC medicines are suspected of causing Medication Overuse Headache (MOH) if taken consistently for more than two days a week.” You can try taking a common migraine medication recommended by your doctor to assess the individual effects. For example, Excedrin is a common migraine medication for migraine patients. However, do note that these migraine cocktails might work differently as our bodies respond differently.

Migraine Vitamin Cocktails

As the name suggests, migraine vitamin cocktails consist of a combination of various vitamins and supplements that are commonly used to help migraine patients cope with migraine. Here are some common migraine vitamin cocktail ingredients:

  • Vitamin B12: Also known as riboflavin, Vitamin B12 may help reduce the frequency of migraines in people who are deficient in it. In a small study, people who took 400 mg of riboflavin daily for six months reported half the number of headaches per month compared to before and reduced their use of other medications. 
  • Vitamin D: Vitamin D may also be helpful in reducing the frequency of migraines, although the exact mechanism is not clear. In a study, combining vitamin D3 and simvastatin, a cholesterol-lowering drug, reduced the number of migraines per month by an average of eight to nine in people who had four to 14 migraines per month. The recommended dose is 1,000 IU twice per day, and it is generally considered safe, although it can cause various side effects when taken in excess. 
  • Magnesium: It is a mineral that is found in the body and in many foods, may be effective in reducing the frequency of migraines in people with low levels of magnesium. In a study, people who took 600 mg of magnesium daily for 12 weeks had a 41.6% reduction in the frequency of migraines during the last four weeks of the study and took fewer medications to treat their symptoms.

Ultimately, it is important to consult your migraine doctor or neurologist to assess the effectiveness of these migraine cocktails, especially when you are making an OTC migraine cocktail at home. You can use a migraine diary, like Migraine Buddy to find patterns in the efficacy of the migraine cocktails.

Download Migraine Buddy now!


“Migraine Cocktails: What They Are and Why They Are Misunderstood.” American Migraine Foundation, 10 Feb. 2022, https://americanmigrainefoundation.org/resource-library/migraine-cocktail/. Accessed 27 Dec. 2022.

This article was contributed by Michelle Florero. Michelle is part of the Content Writing Team of #MBvolunteer, a volunteering initiative of Migraine Buddy. Michelle enjoys singing and hiking during her free time and uses Migraine Buddy to help manage migraine attacks. If you would like to contribute your writing or design expertise like Michelle, you can volunteer with Migraine Buddy here.

Jenny from Migraine Buddy

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